Determinants of neonatal seizure among neonates admitted to neonatal intensive care units in the Awi Zone hospitals, 2023: A multi-center unmatched case control study.

ABSTRACT

Background: Neonatal seizure is a common medical emergency that signals severe insult to the neonatal brain. It is a major risk factor for neonatal morbidity and mortality. It has a wide worldwide variation, ranging from 5 per 1000 live births in the United States of America to 39.5 per 1000 live births in Kenya. To decrease this significant figure, it is better to investigate its causes further. Therefore, this study aimed to assess its determinants since there was no prior evidence about it in the context of study area. Objective: Aim to assess the determinants of neonatal seizures among neonates admitted to neonatal intensive care units in the Awi Zone Hospitals, 2023. Methods: An institution based unmatched case-control study was conducted on 531 admitted eligible neonates from January 1, 2023, to May 30, 2023. A pretested tool was employed to collect data. The collected data were coded, edited, and entered into Epi-data version 3.1 and then exported to SPSS 26. Chi-square and odds ratios were used to assess the relationship between factors associated with the occurrence of neonatal seizure. Model goodness of fit was tested by Hosmer and Lemeshow. Bivariate and multivariate analysis was declared at P < 0.25 and P < 0.05 respectively to show a significant association with neonatal seizure at a 95 % level of significance. Results: A total of 506 (130 cases and 376 controls) of admitted neonates were used in the final analysis model. Neonates admitted within 24 h of birth [AOR; 5.98 (95 %, CI 2.18-16.43)], gestational age <32 weeks [AOR; 2.89 (95 %, CI 1.29-6.53)], body temperature >37.5 °C [AOR; 4.82 (95 %, CI 1.82-12.76)], blood glucose level <40 g/dl [AOR; 4.95 (95 %, CI 2.06,11.88)], neonatal sepsis [AOR; 2.79 (95 %, CI 1.46-5.35)] and perinatal asphyxia [AOR; 8.25 (95 %, CI 4.23, 16.12)] were found to be determinants of neonatal seizure. Conclusion: and recommendations: In this study, neonatal seizure was determined by the factors of neonatal age, gestational age<32 weeks, body temperature >37.5 °C, blood glucose level <40 g/dl, neonatal sepsis, and perinatal asphyxia. Therefore, the presence of such factors requires prompt recognition and treatment.